Think -upstream- to improve health in the United States

Steven Woolf, MD, MPHORLANDO, Fla. — Dr. Steven Woolf, a family medicine physician and epidemiologist trained in public health, encouraged attendees at the 2016 Catholic Health Assembly to explore how support of education, opportunities for income advancement and better neighborhood environments can lead to healthier communities and individuals.

Woolf, a professor of family medicine and population health, directs the Virginia Commonwealth University Center on Society and Health. Speaking at the Catholic Health Assembly on Monday, June 6, he said health outcomes in the United States are worse than those in other developed nations, and added, "The notion that we are sicker than people in other developed countries is not widely understood."

He said that income and education matter enormously in health over an individual's lifetime. Data show the higher someone's education, and the higher someone's income, the better their health at every stage of life. Addressing his fellow physicians in the audience of Catholic health executives, he said, "Getting kids to graduate high school is way more important than any prescription you'll ever write."

Woolf said the reasons why education matters to health and disease burden are complex, but, simply put, in a knowledge economy, a good education often leads to a better paying job.

More income often allows someone the opportunity to live in a safe neighborhood and send their kids to good schools. And conversely, people who live in poverty face high stressors including higher risk of being a crime victim and the economic instability that comes with poor paying jobs. "It is often said that zip code is more important than genetic code" in determining an individual's health, he said.

Every step on the income level is correlated with better health. But, Woolf added, rich people in the United States also die sooner than rich people in other countries.

Woolf said countries that have greater longevity and better health status in comparison to the U.S. spend a great deal less on health care and a great deal more on social services than the U.S.

He spoke about the positive change being driven in pockets of the U.S. by the "collective impact movement." In places including San Diego and the Atlanta neighborhood of East Lake many sectors of the community have joined together to take responsibility for improving community health, he said.